Important facts & figures Alcohol and Health Important facts & figures

Alcohol Ethyl alcohol or ethanol An intoxicating by-product of fermentation, which uses yeast to change the sugars in food into alcohol (grains, fruits…) Alcohol content is expressed as a percentage of volume or weight Central nervous system depressant Different types of alcohol – rubbing, etc. Is a very small molecule and is soluble in “lipid” and water solutions. Because of these properties, alcohol gets into the bloodstream very easily and also crosses the blood brain barrier. Increased turnover of norepinephrine and dopamine Decreased transmission in acetylcholine systems Increased transmission in GABA systems Increased production of beta-endorphin in the hypothalamus

Proof The value is twice the percentage of alcohol in the solution The percentage is how much alcohol is in water Pure alcohol is 200 proof or 100% alcohol Pure alcohol is odorless and clear Measured using a Hydrometer – measures the density of the solution

*Malt liquor – looks and tastes like beer, contains 50% more ethanol What’s a drink? Shot -1.5 oz 40% alcohol 80 proof Wine - 5 oz 11% alcohol 22 proof Beer or wine cooler -12 oz 4% alcohol 8 proof *Malt liquor – looks and tastes like beer, contains 50% more ethanol Liquor – 1.5 ounces Vodka, Whiskey, Rum, Gin Wine – 5 ounces Chablis, White Wine, Red Wine, Merlot, Chardonnay, White Zinfandel Beer/Wine Coolers – 12 ounces Types – Many Malt – Mikes hard lemonade, Smirnoff ice, etc SOLO cups – 18 & 9 oz.

What’s a drink? Popular beverages measured by the number of drinks in each serving Drink Shots #of drinks 1 Solo beer 1.5 1 Solo wine 3.5 12 oz beer 1 Cosmopolitan 3 3 L I Ice Tea 5 5 Rum & Coke 2 2

Alcohol & Your Body Mouth and Esophagus Is an irritant to the delicate linings of the throat and food pipe It burns as it goes down Cancer Dulls the taste and smell, reduces desire to eat

Alcohol & Your Body Stomach & Intestines Approximately 20-25% of the alcohol goes through the walls of the stomach directly into the bloodstream The remainder goes into the small intestine, where it passes through the intestinal walls and into the bloodstream

Alcohol & Your Body Stomach & Intestines Critical factor on the rate of absorption into the bloodstream is dependent on the emptying time of the stomach (ie food present) Causes irritation to the lining of the stomach, resulting in ulcers Blocks absorption of the key vitamins in the small intestine

Alcohol & Your Body Heart Affected by the lack of vitamins Pumping action of heart is weakened Heart failure can result from long time use Causes inflammation of the heart muscle

Alcohol & Your Body Liver 95% of alcohol is broken down in the liver Breaks down alcohol into acetaldehyde by the enzyme alcohol dehydrogenase, and then into acetic acid by the enzyme acetaldehyde dehyrdogenase. Next, the acetate is converted into fats or carbon dioxide and water. The fats are mostly deposited locally which leads to the characteristic “beer belly". Prefers fatty acids as its fuel – but when alcohol is around, the liver is forced to use it instead

Alcohol & Your Body Liver Inflames the cells of the liver, causing them to swell and blocking the tiny canal to the small intestine. Fatty acids build up as plaques around liver cells and those cells begin to die, leading to Cirrhosis If damaged then certain toxins build up, leading to Jaundice Alcoholism is the main reason for cirrhosis of liver The liver breaks down alcohols into acetaldehyde by the enzyme alcohol dehydrogenase, and then into acetic acid by the enzyme acetaldehyde dehydrogenase. Next, the acetate is converted into fats or carbon dioxide and water. The fats are mostly deposited locally which leads to the characteristic "beer belly". Chronic drinkers, however, so tax this metabolic pathway that things go awry: fatty acids build up as plaques in the capillaries around liver cells and those cells begin to die, which leads to the liver disease cirrhosis. The liver is part of the body's filtration system and if it is damaged then certain toxins build up, thus leading to symptoms of jaundice. The alcohol dehydrogenase of women is less effective than that of men. Because of the higher ammounts of water in women's bodies, they become intoxicated more quickly than men. Some people, especially those of East Asian descent, have a genetic mutation in their acetaldehyde dehydrogenase gene, resulting in less potent acetaldehyde dehydrogenase. This leads to a buildup of acetaldehyde after alcohol consumption, causing the alcohol flush reaction with hangover-like symptoms such as flushing, nausea, and dizziness. These people are unable to drink much alcohol before feeling sick, and are therefore less susceptible to alcoholism.

Alcohol & Your Body Brain Ethanol is quickly absorbed into the bloodstream and reaches the brain As a small molecule, it is able to cross the blood-brain barrier Depresses many functions of the brain and nervous system, such as Coordination, orientation, alertness, breathing, processing of information and making decisions Remember – alcohol is a depressant! Slows many functions of the brain

Alcohol & Your Body Brain Reduces the amount of brain tissue and increases the size of the ventricles Can kill brain cells which never return Deprives the brain of vitamins and other food substances Deficiencies of Thiamine can lead to serious mental disturbance Alcohol works on the GABA (gamma-aminobutyric acid) system at the synaptic level, and it has a rapid onset of action. Essentially, it causes the GABA receptor, which is an ion channel, to remain open longer than it does without the addition of ethanol into the synaptic cleft (the space between two neurons, or brain cells). This causes more negatively charged particles, called ions, to enter brain cells than they would under normal conditions. The overall effect is to slow the functional processes of the brain cell. GABA is commonly known as the brain's "brake" mechanism.

Alcohol & Your Body Bladder & Kidneys Inflames the lining of the bladder, making it unable to stretch properly Causes increased loss of fluids because it is irritating – causes dehydration Depresses the antidiuretic hormone which causes the kidneys to reabsorb water – causes the loss of water Leads to vitamin deficiencies

Alcohol & Your Body Reproductive System Sexual functioning can be impaired and deteriorate Male prostate gland may swell which inhibits performance Inhibits ability to climax during intercourse for men and women Can result in impotence and infertility (long term) Higher risk of breast cancer for women Irregular periods for women may develop Birth control pill may speed up absorption rate of alcohol

Alcohol & Your Body Immune System Lowers the effectiveness of the immune system Increased risk of developing viruses/flu

Factors that Influence Determines how the alcohol will make you feel Alcohol content – It is not how many drinks you have – it is the alcohol content that is important Body weight – generally, the less you weigh, the more affected you will be by the alcohol

Factors that Influence Age Gender Amount of food eaten Other drugs or medicines taken Fatigue – stronger effect of alcohol when tired Emotional state – mood can make a difference in how you react – does not alter BAC Drinking time Menstrual cycle, sick The faster you consume the alcohol – the faster you will increase the BAC. At a slower rate, the body will break down the alcohol Remember, the body breaks down one drink per hour Food – less food in the stomach increases the effects of alcohol. Fats and proteins decrease the absorption time Eat foods that digest slowly ie, meat, cheese, grains, nuts Avoid salty foods that tend to increase thirst and drinking Medications may increase effects of alcohol. Never mix – check with your health care professional Refer to handout

Factors that Influence Men Higher muscle mass Higher alcohol enzyme More water Breakdown alcohol at a faster pace than women Women Higher fat content Less alcohol enzyme Less water Breakdown alcohol at a slower pace than men Menstruation Birth control pills Women are affected by alcohol more rapidly because they tend to have a higher proportion of body fat than men. As fat cannot absorb alcohol, it is concentrated at higher levels in the blood. Women also have less of a gastric or stomach enzyme (dehydrogenase) that metabolizes or breaks down alcohol before it enters the bloodstream. Because of this, women absorb up to nearly 30% more alcohol into their bloodstream than men of the same height and weight who drink the same amount of alcohol. Hormone changes during the menstrual cycle can also affect alcohol metabolism adversely, increasing the impact of alcohol. Conversely, studies have shown that taking the birth control pill affects the way women's bodies process alcohol, leading to higher blood alcohol concentrations (BAC) and intensifying the effects of intoxication.

Tolerance Your body’s way of adapting to alcohol use Humans develop tolerance when their brain functions adapt to compensate for the disruption caused by alcohol in both their behavior and their bodily functions The person drinks more to get the high – can lead to problems and addiction Means that after continued drinking, consuming an identical amount of alcohol produces a lesser effect, or more alcohol is necessary to produce the original effect It’s like practice

Effects – In low doses A relaxing effect Reduces tension Lowers inhibitions Impairs concentration Slows reflexes Impairs reaction time Reduces coordination

Effects – In medium does Slurred speech Drowsiness Altered emotions Loss of coordination

Effects – In high doses Vomiting Breathing difficulties Unconsciousness Coma Your body views alcohol as a toxin – it wants to throw it up when there is too much Talk about difference between black out and passing out Show Cosby Video

BAC Blood Alcohol Concentration The amount of alcohol in the bloodstream Measured in percentages Example: Having a BAC of 0.10 percent means that a person has 10 drops of alcohol per 100 drops of blood in they body 10% of the blood content is alcohol

BAC With each sip of alcohol, your BAC rises BAC refers to your body’s ability to process the alcohol in your bloodstream regardless of how you feel Your BAC can pass the legal limit before you feel it PA’s legal limit: 0.08

BAC No two people will react to the same drink in the same way There are many factors that determine how alcohol will make you feel Remember that BAC is a constant and CANNOT be changed once the alcohol goes into the body

BAC = (150/body weight) (%ethanol/50) (ounces consumed) (0.025) How to calculate your BAC BAC = (150/body weight) (%ethanol/50) (ounces consumed) (0.025) Example: 175 lb man who drinks four 12 oz cans of beer (150/175) (4/50) (48) (0.025) = .86 x .08 x 48 x .025 = .08% BAC 12 oz of beer is 4% alcohol Virtual bar BAC vs. Tolerance Refer to hand out

BAC Remember… BAC continues to rise 30-90 minutes after the drinking has stopped Alcohol leaves the body approximately one drink per hour Refer to hand out

The following tables illustrate the effects of alcohol consumption on BAC levels and driving skills. This data should be used only as a general reference for the effects of alcohol b/c body weight and other variables may influence the results. Also, some states define the limit of legal intoxication at a lower blood alcohol level (0.08%) SUCH AS PA For people over 21 with a BAC of .08 or higher, it is against the law to drive. Persons under 21 must obey a zero tolerance law and may not exceed a BAC of .02.

Determining BAC using a Breathalyzer How is it possible to determine the level of alcohol concentration in the blood by using a person's breath? Unlike milk or fruit juice, the body does not digest alcohol. Rather, it is absorbed through the membranes in a person's mouth, throat, stomach, and intestines. Once absorbed by the body, the alcohol passes immediately into the bloodstream, where it circulates until it is expelled through evaporation in the lungs. Evaporation occurs because alcohol is "volatile" in a solution, meaning that its molecules do not combine with the liquid that it mixes with. Due to this volatility, as the blood passes through the lungs, some of the alcohol passes over the alveoli (the lungs' air sacs), allowing it to be released by the person's breath.

Determining BAC using a Breathalyzer The expulsion of the evaporated alcohol through the breath permits the BAC to be accurately measured, since the percent alcohol being expelled contains the same level of alcohol that is contained in the blood. The amount of alcohol in 2,100 ml of expelled breath is exactly equivalent to the amount of alcohol in 1 ml of blood. With these equivalent measures in mind, it is possible to attain an accurate measure of the driver's intoxication, based on the figures set for legal limits. http://www.essortment.com/hobbies/breathalyzerpol_sext.htm

The morning after the night before… Hangover A lot of theories about why they occur Accumulation of acetaldehyde Dehydration Depletion of important enzyme systems needed to maintain routine functioning Metabolism of different types of alcohol beverages Congeners – natural by-products of fermentation By products of fermentation and preparation of alcohol beverages. Congeners are responsible for the different smells, tastes, and colors of alcoholic beverages. Many believe that the reactions different people have to these congeners might have something to do with the potential hangover effect.

How do you sober up? Take a couple minutes to think of ways you’ve heard to sober up quickly…

What you need Rest and time! Your body won’t get into a deep sleep - REM

The Problem Binge Drinking

Binge Drinking Greater than 4 drinks “in a sitting” for women Greater than 5 drinks “in a sitting” for men In a sitting – per occasion/in a single session Encourage our peers to use the language heavy or risky drinking If I’m drinking one drink per hour over a period of time, is it still binge drinking if I have 4-5 drinks in one evening?

Alcohol Poisoning Main signs Low respirations (less than 8 breaths per minute) Unarousable Slurred speech Passed out Vomiting Cold, sweaty, and/or bluish skin/nails (late sign)

What to do Call for help! Never leave them alone! Public safety, VEMS, Residence Life, 911 (depends on location) Place person on their side Do not feed or give water (or coffee) or medications Do not walk them around Never let someone “sleep it off” without monitoring them